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Gemcitabine and Flavopiridol in Treating Patients With Solid Tumors
This study is currently recruiting participants.
Verified by National Cancer Institute (NCI), October 2007
First Received: November 4, 2003   Last Updated: April 30, 2009   History of Changes
Sponsor: Dana-Farber Cancer Institute
Collaborator: National Cancer Institute (NCI)
Information provided by: National Cancer Institute (NCI)
ClinicalTrials.gov Identifier: NCT00072436
  Purpose

RATIONALE: Drugs used in chemotherapy, such as gemcitabine and flavopiridol, use different ways to stop tumor cells from dividing so they stop growing or die. Combining more than one drug may kill more tumor cells.

PURPOSE: This phase I trial is studying the side effects and best dose of gemcitabine and flavopiridol in treating patients with solid tumors.


Condition Intervention Phase
Unspecified Adult Solid Tumor, Protocol Specific
Drug: alvocidib
Drug: gemcitabine hydrochloride
Phase I

Study Type: Interventional
Study Design: Treatment
Official Title: A Phase I Trial Of Gemcitabine Followed By A Short Infusion Of Flavopiridol In Patients With Solid Tumors

Resource links provided by NLM:


Further study details as provided by National Cancer Institute (NCI):

Primary Outcome Measures:
  • Maximum tolerated dose as measured by safety and observed data collected every 28 days [ Designated as safety issue: Yes ]

Secondary Outcome Measures:
  • Antitumor activity as measured by CT, MRI, or positron emission test (PET) scans at every other course [ Designated as safety issue: No ]

Estimated Enrollment: 80
Study Start Date: September 2003
Estimated Primary Completion Date: November 2005 (Final data collection date for primary outcome measure)
Detailed Description:

OBJECTIVES:

Primary

  • Determine the maximum tolerated dose of gemcitabine and flavopiridol in patients with solid tumors.

Secondary

  • Determine the safety profile and toxic effects of this regimen in these patients.
  • Determine the pharmacokinetics of flavopiridol with and without gemcitabine in these patients.
  • Determine, using pharmacodynamic assays, the activity of flavopiridol as a cdk inhibitor in these patients.
  • Determine, using pharmacodynamic assays, the markers of this regimen in these patients.

OUTLINE: This is a dose-escalation, multicenter study.

Some patients receive an initial dose of flavopiridol IV over 1-7 hours on day 1 (course 0). Beginning 1 week later and for all subsequent courses, all patients receive gemcitabine IV over 60-150 minutes on days 1 and 15 and flavopiridol IV over 1-7 hours on days 2 and 16. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity.

Cohorts of 3-6 patients receive escalating doses of gemcitabine and flavopiridol until the maximum tolerated dose (MTD) is determined. The MTD is defined as the dose preceding that at which 2 of 3 or 2 of 6 patients experience dose-limiting toxicity. Once the MTD is determined, up to 10 additional patients receive treatment at that dose.

Patients are followed at 30 days after study completion.

PROJECTED ACCRUAL: A total of 40-80 patients will be accrued for this study.

  Eligibility

Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

DISEASE CHARACTERISTICS:

  • Histologically confirmed solid tumor for which gemcitabine is a treatment option OR for which no efficacious therapy exists
  • Must meet criteria for 1 of the following:

    • Measurable disease

      • At least 1 unidimensionally measurable lesion at least 20 mm by conventional techniques OR at least 10 mm by spiral CT scan
    • Nonmeasurable disease, including any of the following:

      • Small lesions (less than 20 mm by conventional techniques OR less than 10 mm by spiral CT scan)
      • Bone lesions
      • Cytologically positive pleural or peritoneal disease
      • Elevated tumor markers (e.g., carcinoembryonic antigen, CA 125, CA 19-9, or other tumor marker)
      • Multinodular or confluent nonmeasurable pulmonary, hepatic, adrenal, intra-abdominal, or skin metastases
  • No active CNS metastases

    • Previously treated CNS metastases must be stable with no symptoms for 4 weeks after completion of treatment AND patient must be off steroid therapy or on a stable dose for at least the past 2 weeks
  • No known leptomeningeal metastases

PATIENT CHARACTERISTICS:

Age

  • 18 and over

Performance status

  • ECOG 0-1

Life expectancy

  • Not specified

Hematopoietic

  • Absolute neutrophil count at least 1,500/mm^3
  • Platelet count at least 100,000/mm^3

Hepatic

  • See Disease Characteristics
  • Bilirubin no greater than 1.5 mg/dL
  • SGOT no greater than 2.5 times upper limit of normal

Renal

  • See Disease Characteristics
  • Creatinine no greater than 1.5 mg/dL OR
  • Creatinine clearance at least 50 mL/min

Cardiovascular

  • None of the following within the past 6 months:

    • Myocardial infarction
    • Unstable angina
    • Transient ischemic attack
    • Cerebrovascular accident
  • No new cardiac arrhythmia possibly related to cardiac ischemia
  • No large and potentially symptomatic pericardial effusion
  • No cardiac disease that would preclude study participation

Pulmonary

  • See Disease Characteristics
  • No pulmonary embolism within the past 6 months
  • No large and potentially symptomatic pleural effusion
  • No pulmonary disease that would preclude study participation

Gastrointestinal

  • No intractable emesis
  • No grade 2 or greater chronic diarrheal disease within the past 6 months

Other

  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective contraception
  • No active infection
  • No severe malnutrition

PRIOR CONCURRENT THERAPY:

Biologic therapy

  • Not specified

Chemotherapy

  • No more than 2 prior chemotherapy regimens

    • Prior combined modality therapy (e.g., full-dose chemotherapy with radiosensitizing chemotherapy and radiotherapy) is considered 1 prior regimen if all therapy was delivered as part of 1 comprehensive treatment plan
  • More than 4 weeks since prior chemotherapy (6 weeks for nitrosoureas or mitomycin) and recovered
  • No other concurrent chemotherapy

Endocrine therapy

  • See Disease Characteristics

Radiotherapy

  • See Chemotherapy
  • At least 6 months since prior radiotherapy to the lung parenchyma or mediastinum and no evidence of radiation pneumonitis on chest CT scan
  • At least 4 weeks since other prior radiotherapy and recovered
  • No prior radiotherapy to more than 50% of marrow volume
  • No concurrent radiotherapy

Surgery

  • Not specified
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00072436

Locations
United States, Massachusetts
Dana-Farber/Harvard Cancer Center at Dana Farber Cancer Institute Recruiting
Boston, Massachusetts, United States, 02115
Contact: Geoffrey Shapiro, MD, PhD     617-632-4942     geoffrey_shapiro@dfci.harvard.edu    
Massachusetts General Hospital Recruiting
Boston, Massachusetts, United States, 02114
Contact: Clinical Trials Office - Massachusetts General Hospital     877-726-5130        
United States, New York
Memorial Sloan-Kettering Cancer Center Recruiting
New York, New York, United States, 10065
Contact: Gary K. Schwartz, MD     212-639-8324        
Sponsors and Collaborators
Dana-Farber Cancer Institute
Investigators
Study Chair: Geoffrey Shapiro, MD, PhD Dana-Farber Cancer Institute
  More Information

Additional Information:
No publications provided

Study ID Numbers: CDR0000339727, DFCI-03110, NCI-6051
Study First Received: November 4, 2003
Last Updated: April 30, 2009
ClinicalTrials.gov Identifier: NCT00072436     History of Changes
Health Authority: Unspecified

Keywords provided by National Cancer Institute (NCI):
unspecified adult solid tumor, protocol specific

Additional relevant MeSH terms:
Antimetabolites
Anti-Infective Agents
Antimetabolites, Antineoplastic
Immunologic Factors
Molecular Mechanisms of Pharmacological Action
Antineoplastic Agents
Growth Substances
Physiological Effects of Drugs
Enzyme Inhibitors
Protein Kinase Inhibitors
Antiviral Agents
Immunosuppressive Agents
Pharmacologic Actions
Flavopiridol
Neoplasms
Radiation-Sensitizing Agents
Therapeutic Uses
Growth Inhibitors
Gemcitabine

ClinicalTrials.gov processed this record on November 09, 2009